Courtney Nicole Shields, LCADC, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

255310 Issued in KY

Practice address

805 Alexa Dr Ste D
Mt Sterling, KY 40353-1000

Phone

(859) 432-8002

Fax

(859) 432-8483

NPI assigned

Nov 20, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

New Vista of the Bluegrass IncGroup PAC ID 6608773619, 55 clinicians

Gateway Recovery Clinic, PLLCGroup PAC ID 9830423326, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

52.29 of 100Reported as group

Quality

17.07

Improvement activities

40

Cost

76.34

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gateway Recovery Clinic, PLLC

  • Psychiatry Physician
  • Mt Sterling, KY
  • NPI 1003377011
  Medicare reassignment Care Compare group NPD
• New Vista of the Bluegrass Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frankfort, KY
  • NPI 1790731081
  Medicare reassignment Care Compare group NPD
• New Vista of the Bluegrass

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, KY
  • NPI 1366482317
  NPD
• New Vista of the Bluegrass Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, KY
  • NPI 1023359783
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1700390218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 ALEXA DR STE D",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531000",
            "telephone_number": "859-432-8002",
            "fax_number": "859-432-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 ALEXA DR STE D",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531000",
            "telephone_number": "859-432-8002",
            "fax_number": "859-432-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "COURTNEY",
        "middle_name": "NICOLE",
        "credential": "LCADC, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "246586",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy Sexton
• William Michael Sexton, D.M.D
• Heather Shaffer-Kegley, PHARMD
• James Deane Shannon, PA
• Jana A Shepherd, DPT
• Michael Shoopman, PSS
• Alan Dee Shultz, MD
• William Shultz, DO
• Wesley Simmons
• Robin Mantooth Simpson, OTR/L

• Clinical Social Worker in Mt Sterling, KY
• Providers in Mt Sterling, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.